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Query: UMLS:C0684249 (lung carcinoma)
 23,830 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In this study, we investigated activity of matrix metalloproteinase (MMP) of lung cancer by newly developed film in situ zymography (FIZ) stamp method, which allows visual localization of gelatinolytic activity within the cut surface of a tumor. We performed FIZ stamp method and conventional gelatin zymography in 39 resected specimen of lung cancer. The degree of gelatinolytic activity was scored (FIZ score) and correlated with the clinicopathological factors of the tumor. FIZ score of normal lung was very low. Lung cancer tissue had consistently higher FIZ score than the matched normal lung tissue. There were statistically significant differences in the FIZ score according to the pathological stage (P = 0.0015), nodal status (P = 0.0007) and lymphatic invasion (P = 0.0004). Direct correlation was observed between the FIZ score and MMP-2 activity (rho = 0.568, P = 0.0030) as quantitated using conventional gelatin zymography. MMP-2 may play an important role in the lymphatic invasion of lung cancer. FIZ stamp method may be a simple and useful diagnostic aid for the presence of cancer cells in the resected specimen.
Lung Cancer 2003 Feb
PMID:Gelatinolytic activity of matrix metalloproteinase in lung cancer studied using film in situ zymography stamp method. 1258 63

We have evaluated the prognostic value of 22 pretreatment attributes in 436 small cell lung cancer (SCLC) patients included in a prospective multicenter study with a minimum 5-year follow-up. Pretreatment clinical and laboratory parameters were registered. Possible prognostic factors were evaluated by univariate analysis (log rank test) and by the Cox multivariate regression model. In the univariate analysis of all patients, only age, nodal metastasis, and skin metastasis were not associated with survival. The multivariate Cox model identified gender, extent of disease, performance status (PS), weight loss, platelet count, LDH, and NSE as independent prognostic factors. In subset multivariate analyses according to extent of disease, we found haemoglobin level, PS, NSE, and total WBC as significant prognostic indicators for survival in limited-stage disease (LD-SCLC), while PS, weight loss, LDH, number of metastases, liver metastases, and brain metastases were identified as independent prognostic factors in extensive-stage disease (ED-SCLC). There was a significant correlation between serum LDH and NSE levels. In conclusion, gender, extent of disease, PS, weight loss, haemoglobin, WBC count, platelet count, LDH, and NSE were all found to be independent prognostic factors for SCLC survival. However, the prognostic value of these factors depends highly on whether all or subsets of SCLC patients are studied.
Lung Cancer 2003 Mar
PMID:The value of prognostic factors in small cell lung cancer: results from a randomised multicenter study with minimum 5 year follow-up. 1260 69

The purpose of this study was to make a pathological evaluation of the tumor response and the lung injury of non-small cell lung cancer (NSCLC) patients after carbon ion therapy. We enrolled four NSCLC patients with chest wall invasion but without nodal and distant metastasis (T3N0M0). Only primary lesions were irradiated with carbon ions, followed by surgical resection. The patients consisted of three males and one female varying by age from 54 to 73 (average 66.3). Total treatment dose was 59.4 and 64.8 GyE, respectively, administered in 18 fractions over 6 weeks, or 72.0 GyE in 16 fractions over 4 weeks. Resection after radiation therapy was performed as a combination of lobectomy, lymph node dissection and chest wall surgery. After fixation, the lung was sliced into thin sections to match the CT image. Each slice was anatomically identified and the slices were compared with each other subjected to pathological analysis. No tumor cells were observed in two cases. The other two cases exhibited only a few tumor cells sparsely distributed in the lung tissue. There was evidence of dense pulmonary fibrosis in the limited space surrounding primary tumors, but its density was found to rapidly decrease in the narrow area toward the outside. The rate at which its density subsided mirrored the rapid decrease in the planning CT dose distribution. Microscopy showed no evidence of fibrosis in any of the fields irradiated with less than 15 GyE. Microscopy confirmed an outstanding tumor response with limited pulmonary fibrosis. This substantiates the superior dose localization and strong biological effect of carbon ion beams with a Bragg peak in the lung. The pathological findings have thus provided evidence of the safety and effectiveness of carbon beam therapy in the treatment of NSCLC.
Lung Cancer 2003 Oct
PMID:Preoperative carbon ion radiotherapy for non-small cell lung cancer with chest wall invasion--pathological findings concerning tumor response and radiation induced lung injury in the resected organs. 1451 92

To study the behavior and possible correlations of neuron-specific enolase (NSE) with other clinicobiological parameters, we measured the cytosolic levels of this marker by means of an immunoradiometric assay (IRMA) in 95 squamous cell lung carcinoma samples. We also analyzed the levels of pS2, tissue-type plasminogen activator (t-PA), hyaluronic acid (HA), free beta subunit of human chorionic gonadotropin (beta-HCG), CYFRA 21.1 and CA 125 in cytosol. On the cell surface we analyzed the concentrations of epidermal growth factor receptor (EGFR), HA, erbB-2 oncoprotein, CD44s, CD44v5 and CD44v6. Other parameters considered were clinical stage, lymph node involvement, histological grade (HG), ploidy and the cellular S-phase fraction measured by flow cytometry on nuclei obtained from fresh tissues. In the 95 squamous cell carcinomas the cytosolic levels of NSE varied from 4.5 to 2235 ng/mg protein (median: 267) and were significantly higher (p < 0.001) than those observed in 38 samples of normal pulmonary tissue obtained from the same patients (range: 56-657; median: 141.5). When classifying tumors according to the different parameters analyzed, we observed that the levels of NSE were higher in aneuploid than in diploid cases (p = 0.046) and in those that were HG3 than in those that were HG2 (p < 0.001). Tumors with high NSE levels (> 422 ng/mg protein; 75th percentile) were more likely to have high S-phase values (p = 0.012) and were more frequently aneuploid (p = 0.038) and HG3 (p < 0.001) than those with low levels of NSE (< 180 ng/mg protein; 25th percentile). These results lead us to the following conclusions: 1) the cytosolic concentrations of NSE are significantly higher in squamous cell carcinomas than in healthy pulmonary tissue, and 2) the cytosolic concentrations of NSE are not correlated with clinical stage or nodal involvement. However, in our study higher levels of the enzyme were statistically correlated with aneuploidy, histological grade 3 and S-phase. This may explain its association with poorer outcome and progression, but also the more favorable response of tumors with elevated NSE to chemotherapy, as suggested by other groups.
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PMID:Cytosolic levels of neuron-specific enolase in squamous cell carcinomas of the lung. 1453 89

This study prospectively evaluated the usefulness of thoracoscopy for staging non-small cell lung cancer in 105 consecutive patients. A comparison was made of TNM stage grouping classification according to clinical disease, thoracoscopic data, and pathological findings. In 40 (38%) patients, thoracoscopy was unreliable for assessing extent of disease due to pleural symphysis. In 13 T1 clinical lesions, thoracoscopy was unreliable in 5, clinical and thoracoscopic staging concurred in 4, but 4 cases changed to T2. In 62 T2 clinical lesions, thoracoscopy was not feasible due to technical difficulties in 21 (34%); however, in the remaining 41 cases, 6 lesions changed to T3 and 1 to T4. In the group of 23 T3 or T doubtful clinical disease, thoracoscopy was conclusive, whereas in 12 T4 clinical lesions, thoracoscopy contributed for tailoring treatment strategies. With regard to N stage, 72 N0 clinical cases, thoracoscopy revealed false negatives in 25%. N1 clinical lesions were not evaluated due to the small number of patients. In 30 N2 clinical lesions, thoracoscopy was incomplete in 11. In another 11 cases, mediastinal node involvement at nodal groups not accessible by mediastinoscopy was confirmed by thoracoscopy. Clinical and thoracoscopic findings were not concurrent in eight cases, therefore in clinical N2 lesions, the diagnostic accuracy of thoracoscopy was 63%. Only one case of unsuspected pleural metastasis was detected. Thoracoscopy-related complications occurred in nine cases. In summary, video-assisted thoracoscopy was useful for staging T3, T4, and T doubtful clinical disease as well as N2 lesions especially for the surgical exploration of lymph nodes at the lower paratracheal level (region 4), aortopulmonary window (region 5), paraaortic (region 6), posterior subcarinal space (region 7), paraesophageal (region 8), and inferior pulmonary ligament (region 9).
Lung Cancer 2003 Dec
PMID:Clinical value of video-assisted thoracoscopy for preoperative staging of non-small cell lung cancer. A prospective study of 105 patients. 1464 17

Preoperative chemotherapy in patients with stage III non-small-cell lung cancer (NSCLC) remains controversial. Phase II trials utilizing preoperative chemotherapy in selected patients have achieved complete resection rates of 50%-70% with 3-5 year failure-free survival rates of 15%-33%. Between October 1992 and November 1994, 57 adults (50 of whom were evaluable) with surgically staged IIIA NSCLC and pathologically documented ipsilateral mediastinal nodal involvement (N2) were enrolled in a Cancer and Leukemia Group B randomized trial. Preoperative therapy was thought to be critical to facilitating surgical resectability. For patients randomized to the radiotherapy/surgery/radiotherapy (RSR) arm (n = 24), treatment consisted of preoperative radiation therapy (RT) at 40 Gy, surgery, and then additional RT at 14-20 Gy. For patients randomized to the chemotherapy/surgery/chemotherapy/radiotherapy (CSCR) arm (n = 26), treatment consisted of 2 cycles of cisplatin/etoposide with filgrastim support (PE) followed by surgery, 2 more cycles of PE, then RT 54-60 Gy. The total dose of RT on either arm was 54 Gy if completely resected or 60 Gy if incompletely resected or unresected. Clinical characteristics were well balanced between the two arms. Thoracotomy was performed in 42 patients (84%), 28 (67%) of whom had complete resection. The median failure-free and overall survival rates were 12 months (95% confidence interval [CI], 9-23 months) and 23 months (95% CI, 19 months-infinity) for the RSR arm and 11 months (95% CI, 5-20 months) and 18 months (95% CI, 12-32 months) for the CSCR arm. The rates of overall and complete surgical resection, downstaging of nodal involvement, and failure-free (P = 0.92) and overall survival (P = 0.41) did not differ between the two treatment arms. Moreover, in this trial, the chemotherapy regimen was sufficiently toxic to have had a lower completion rate of prescribed therapy in the CSCR arm than in the RSR arm.
Clin Lung Cancer 2002 Sep
PMID:Radiotherapy versus chemotherapy plus radiotherapy in surgically treated IIIA N2 non-small-cell lung cancer. 1465 65

The appropriate patient selection for adjuvant radiotherapy after primary surgical therapy of non-small-cell lung cancer (NSCLC) is unclear. Four thousand thirteen patients diagnosed from 1988-1995 in 9 registry areas of the Survival, Epidemiology, and End Results program who received primary surgical therapy for pathologic stage T1-3 N1/2 M0 NSCLC were identified. County-level and patient-specific variables associated with the use of postoperative radiotherapy (PORT) were studied by multivariate logistic regression analysis. Prognostic factors for cause-specific survival (CSS) and overall survival (OS) were determined by Cox multivariate analysis. Overall, 58% of node-positive patients received PORT. Use of PORT was independently associated with younger age, more advanced nodal disease, no prior cancer, less extensive surgery than pneumonectomy, and patient residence close to a radiotherapy facility. In multivariate analysis of the entire node-positive population, there were no differences in OS or CSS with the use of PORT. In the patients with N2 disease, PORT was associated with improved OS (5-year OS: 16% without PORT, 22% with PORT; P = 0.001) and CSS (5-year CSS: 25% without PORT, 30% with PORT; P = 0.02). Additionally, patients with = 4 nodes involved also had an improved survival in association with PORT (5-year OS: 11% without PORT, 18% with PORT; P = 0.001; 5-year CSS: 17% without PORT, 25% with PORT; P = 0.009). Therefore, recognizing the inherent limitations of a retrospective, registry-based analysis, patients with more advanced nodal disease appear to have an improved survival with the use of PORT.
Clin Lung Cancer 2002 Jul
PMID:Use of postoperative radiotherapy for node-positive non-small-cell lung cancer. 1465 75

We report two cases of breast cancer with endocrine differentiation. Case 1 was a 56-year-old woman with a 2-cm tumor in the upper outer quadrant of the right breast and right axillary lymphadenopathy. Excisional biopsy suggested carcinoma and we performed breast-conserving surgery with lymph node dissection. Histologic examination revealed breast cancer with endocrine differentiation resembling small cell carcinoma of the lung, with one nodal metastasis. Case 2 was a 71-year-old woman with a 2.5-cm tumor in the upper outer quadrant of the right breast. Aspiration cytology suggested carcinoma and we performed mastectomy with lymph node dissection. Histologic examination revealed a carcinoid tumor, as one of the breast cancers with endocrine differentiation, but no nodal metastasis. The two patients are now disease-free 26 and 12 months after surgery, respectively.
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PMID:Breast cancer with endocrine differentiation: report of two cases showing different histologic patterns. 1466 81

Major prognostic factors for early-stage non-small-cell lung cancer (NSCLC) are tumor size and nodal status. It has been suggested that HER2/neu overexpression may be related to poor prognosis in NSCLC. We evaluated the significance of HER2/neu overexpression on survival in patients with NSCLC. Data were collected on 239 patients treated surgically for stage I/II NSCLC between 1987 and 1996. None of the patients received adjuvant chemotherapy or radiation. Formalin-fixed, paraffin-embedded tumor tissue samples were stained with p185/HER2 receptor antibody. Results were reported as positive (2+, 3+) or negative (0, 1+) (Group A). A separate analysis considered only 3+ as positive (Group B). HER2/neu overexpression was seen in 18% in Group A (43 of 239) and 6% in Group B (15 of 239). HER2/neu overexpression was highest in bronchoalveolar cell carcinoma and adenocarcinoma. More stage I tumors were positive than stage II in both groups, but this was significant only in Group A (21% vs. 7%, P = 0.02). No difference was seen with age, gender, or grade for either group. In Group A, the relapse rate was 55% for HER2/neu-overexpressing tumors and 31% for HER2/neu-negative tumors (P = 0.003). Median time to relapse in patients with HER2/neu-positive tumors was 2.9 years; it was not reached in patients with HER2/neu-negative tumors. Median survival of patients with HER2/neu-positive tumors was 3.6 years compared to 5 years in patients with HER2/neu-negative tumors (P = 0.66). In Group B, the relapse rate was 60% for HER2/neu-overexpressing tumors and 33% for negative tumors (P = 0.036). Median time to relapse was 3.4 years in HER2/neu positive and had not been reached in negative tumors. There was no difference in 5-year survival rates for both groups (47% for HER2/neu positive and 50% for negative, P = 0.66).
Clin Lung Cancer 2001 Feb
PMID:Effect of HER2/neu expression on survival in non-small-cell lung cancer. 1470 Apr 81

Positron emission tomography (PET) is a modality that differentiates malignant from benign processes based upon metabolism rather than anatomy. A number of studies have confirmed improved accuracy of PET over computed tomography (CT), but until a few recent studies, most had failed to include satisfactory histologic confirmation. The objective of this study was to compare PET and CT to histologic staging of the mediastinum in patients with non-small-cell lung cancer (NSCLC). Histologic examination of mediastinal lymph nodes (MLNs) was performed on 40 patients with NSCLC at mediastinoscopy and/or at surgical resection. PET scans were interpreted by one of two nuclear medicine physicians, blinded to histology, using CT scans for anatomic localization. CT scans were independently evaluated for mediastinal lymphadenopathy. The overall accuracy, sensitivity, and specificity of PET were 78% (31 of 40), 67% (four of six), and 79% (27 of 34), respectively. The overall accuracy, sensitivity, and specificity of CT were 68% (27 of 40), 50% (three of six), and 71% (24 of 34), respectively. PET was superior to CT at correctly identifying mediastinal nodal metastases; however, both modalities were inferior to the gold standard of surgical staging. PET is more accurate than CT in staging the mediastinum of patients with NSCLC. PET failed to identify lymph node metastasis in 33% of patients with histologically proven MLN involvement, and false positives were present in 15%. At present, mediastinoscopy should remain the standard of care for preoperative mediastinal staging for NSCLC.
Clin Lung Cancer 2001 Feb
PMID:The role of positron emission tomography in evaluating mediastinal lymph node metastases in non-small-cell lung cancer. 1470 Apr 83


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